Addressing the Midlife Mortality Crisis: Place-Based Modeling, Trend Analysis and Policy Interventions

解决中年死亡率危机：基于地点的建模、趋势分析和政策干预

• 批准号: 10583849
• 负责人: Myron P. Gutmann
• 金额: $ 58.12万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583849
• 关键词: Address; Adult; Affect; Age; Alcohol abuse; Algorithms; Area; Attention; Businesses; COVID-19; Cardiometabolic Disease; Cause of Death; Censuses; Cessation of life; Characteristics; Child; Classification; Communicable Diseases; Communities; Complex; County; Crime; Data; Databases; Demographic Analyses; Detection; Development; Differential Mortality; Distress; Drug abuse; Economic Conditions; Economics; Employment; Event; Feedback; Foreclosure; Formulation; Future; Geography; Health Policy; Hepatitis C; Housing; Income; Individual; Inequality; Intervention; Maps; Methods; Modeling; Mortality Determinants; Outcome; Pattern; Policies; Policy Developments; Policy Research; Population; Population Sizes; Procedures; Process; Property; Records; Research; Research Personnel; Resolution; Risk; Risk Factors; Role; Rural; Rural Health; Science; Series; Social Conditions; Spottings; Statistical Data Interpretation; Structure; Testing; Time; Work; aged; design; detection method; experience; innovation; middle age; mortality; mortality risk; novel; policy recommendation; response; social disparities; spatiotemporal; statistics; suicide rate; theories; therapy design; trend; trend analysis

PROJECT SUMMARY This project will study midlife mortality trends by analyzing the local correlates and risk factors of cause of death in their place-based context between 1990 and 2021. Using cause-specific death data, sociodemo- graphic characteristics, and economic trends, the research will generate trajectories of midlife mortality risks for dynamically-derived spatial units. What makes this project innovative and significant is (1) mortality data at the block, zip code or tract level; (2) methods in spatial analysis, time series trajectory determination, and mul- tiscalar statistical analysis; and (3) an innovative and integrated approach to policy research, conducted by a team experienced in demographic analysis, multiscalar spatial and temporal statistics, and rural health policy formulation. This work responds to research and policy discussions regarding potentially-modifiable attributes of places related to rising mortality among middle-aged adults. Several cause-specific mortality trends warrant attention: rising rates of suicides, cardiometabolic diseases, and deaths due to drug or alcohol abuse, along with their interactions with select infectious diseases (e.g., Hepatitis C and COVID-19). The project has five specific aims: (1) For select U.S. states where block- or tract-level mortality data are available, researchers will create a novel micro-scale database with cause-specific mortality records and contextual data including cen- sus-based demographic data, employment and business data, property characteristics, and crime data. (2) The research makes use of an iterative algorithm to identify clusters of micro-units that have common, cause- specific mortality patterns, using community detection methods, in order to identify the most salient levels of spatial units at which processes affecting midlife mortality occur. It also assesses spatial autocorrelation to identify mortality hot- and cold-spots (spatial) and undertakes extreme event detection to identify hot-moments (temporal). (3) The project uses multi-channel sequencing to classify geographic units, for example, where population has grown or diminished, aged, or seen an increase in children, or where the economy has created wealth. These trajectories constitute a set of place-based classifications for later analysis. (4) The project’s analysis will use spatiotemporal models to estimate the effect of local-to-regional determinants of cause-spe- cific mortality in middle-aged adults, with two strategies: (A) Assess the role of different place-based determi- nants of midlife mortality, in order to evaluate theories of midlife mortality differentials and to test specific hy- potheses (e.g., economic distress). (B) Identify the optimal scale at which determinants with the greatest im- pact operate to inform policy recommendations designed to target midlife mortality for specific causes of death. (5) Designing policy interventions is fundamental to the project, which begins with a policy mapping process, and builds on the results of the multiscalar analysis to design intervention strategies targeting the determinants of mortality differentials and the characteristics of places at greatest risk of continued mortality challenges.

项目总结 该项目将通过分析导致中年死亡的当地相关因素和风险因素来研究中年死亡趋势。 1990年至2021年期间，他们在基于地点的背景下死亡。使用特定死因的死亡数据，社会演示- 图表特征和经济趋势，这项研究将产生中年死亡风险的轨迹 动态派生空间单位。使该项目具有创新性和重大意义的是(1) 区块、邮政编码或区域级别；(2)空间分析、时间序列轨迹确定和多维空间分析方法。 标量统计分析；以及(3)创新和综合的政策研究方法，由 在人口分析、多标度时空统计和农村卫生政策方面经验丰富的团队 配方。这项工作回应了有关潜在可修改属性的研究和政策讨论 与中年人死亡率上升有关的地方。几个特定原因的死亡趋势证明 注意：自杀率、心脏代谢性疾病和因药物或酒精滥用而死亡的比例不断上升， 与特定传染病(如丙型肝炎和新冠肺炎)的相互作用。这个项目有五个 具体目标：(1)对于美国某些有区块或区块水平死亡率数据的州，研究人员将 创建一个新的微型数据库，其中包括特定原因的死亡记录和背景数据，包括 基于SU的人口统计数据、就业和商业数据、财产特征和犯罪数据。(2) 这项研究利用一种迭代算法来识别具有共同原因的微型单位集群- 具体的死亡模式，使用社区检测方法，以确定最显著的 影响中年死亡率的过程发生的空间单位。它还评估了空间自相关性 识别死亡热点和冷点(空间)，并进行极端事件检测以识别热点时刻 (时间)。(3)项目使用多通道排序对地理单元进行分类，例如， 人口增长或减少，老龄化，或看到儿童的增加，或经济创造的地方 财富。这些轨迹构成了一套基于地点的分类，以供以后分析。(4)项目的 分析将使用时空模型来估计原因特定的局部到区域决定因素的影响。 通过两种策略：(A)评估不同地点洗涤方法的作用。 为评价中年死亡率差异理论并检验中年死亡率的特异性。 假说(例如，经济困境)。(B)确定具有最大影响的决定因素的最佳规模-- 该协定旨在为旨在针对特定死因的中年死亡率的政策建议提供信息。 (5)设计政策干预措施是该项目的基础，该项目从政策规划过程开始， 并基于多标度分析的结果来设计针对决定因素的干预策略 关于死亡率差异和面临持续死亡挑战风险最大的地区的特点。